No abstract available.
Pulmonary Alveolar Proteinosis*

Humans ; Pulmonary Alveolar Proteinosis/pathology*

Humans ; Infant ; Male ; Pulmonary Alveolar Proteinosis

Pulmonary alveolar proteinosis is characterized by the remittent or progressive accumulation of lipid-rich proteinaceous material within the alveolar sacs in the absence of inflammatory response. Whole-lung lavage is the only consistent treatment for pulmonary alveolar proteinosis. We have utilized whole-lung lavage for the successful treatment of a 62 year-old female patient with pulmonary alveolar proteinosis. There was no persistent complication during the procedure and the postanesthetic recovery except temporary fever and hypoxic event. The patient was symptomatically, physiologically, and radiologically improved within days after the procedures.
Female ; Fever ; Humans ; Middle Aged ; Pulmonary Alveolar Proteinosis* ; Therapeutic Irrigation*

Pulmonary alveolar proteinosis is such an extremely rare disease in Korea, that only a few cases have been reported. Meanwhile five cases were experienced at Seoul National University Hospital over ten years since 1987. We summarized the clinical characteristics and courses of them. Seven cases reported in the literature were included to add data about clinical characteristics and courses although only a few case reports mentioned patient's course. Middle aged male patients were mainly affected. No association with particular environmental or occupational exposure was identified. Dyspnea on exertion was the main symptom. Bilateral crackles were consistent, and bilateral parahilar hazy infiltrations on plain chest radiograph and ground glass opacity on high-resolution CT were characteristic. Superimposed infection was not identified in any patient at the time of diagnosis. Decreased diffusing capacity and hypoxia were present in almost every case. Whole lung lavage proved to be an effective therapeutic measure. The response to treatment was good. Long-term course of the disease, e.g. recurrence rate, is not yet known.
Adult ; Age Distribution ; Aged ; Female ; Hospitals, Public* ; Hospitals, University* ; Human ; Korea ; Male ; Middle Age ; Pulmonary Alveolar Proteinosis/therapy ; Pulmonary Alveolar Proteinosis/radiography ; Pulmonary Alveolar Proteinosis/physiopathology* ; Pulmonary Alveolar Proteinosis/diagnosis ; Sex Distribution ; Smoking/adverse effects

Adult ; Humans ; Male ; Pneumoconiosis ; complications ; Pulmonary Alveolar Proteinosis ; complications

This report describes a 20 year old student who presented with rapidly progressing respiratory dysfunction of one year duration, treated as a case of asthmatic bronchitis. Pulmonary alveolar proteinosis was diagnosed by open lung biopsy and she eventually underwent large volume whole lung lavage under general anesthesia.
Human ; Young Adult ; BRONCHOALVEOLAR LAVAGE ; PULMONARY ALVEOLAR PROTEINOSIS

Asbestos ; toxicity ; Humans ; Occupational Exposure ; adverse effects ; Pulmonary Alveolar Proteinosis

Bronchoalveolar Lavage ; Humans ; Lung ; Pulmonary Alveolar Proteinosis/therapy*

Bronchopulmonary lavage using a double-lumen endotracheal tube is an accepted modality for treatment of pulmonary alveolar proteinosis which characterized by filling of alveolar space with periodic acid-schiff positive proteinaceous material. Massive bronchopulmonary lavage is not without hazard. Improper positioning and inadequate cuff inflation of the endotracheal tube may lead drowning. So correct placement of double-lumen endotracheal tube and confirming complete seperation of the two lungs is important to prevent drowning. And periods of tidal drainage are accompanied with reperfusion to the non-ventilated lung and cause potentially dangerous levels of hypoxemia. One must investigate maneuvers to minimize perfusion to non-ventilated lung and to maximize gas exchange during unilateral lung lavage. The distribution of pulmonary blood flow during unilateral lung lavage can be manipulated by nonocclusive inflation of an ipsilateral pulmonary artery balloon. We report a case of sequential bronchoalveolar lavage in a patient with pulmonary alveolar proteinosis performed safely with pulmonary arterial catherter insertion.
Anoxia ; Bronchoalveolar Lavage* ; Drainage ; Drowning ; Humans ; Inflation, Economic ; Lung ; Perfusion ; Pulmonary Alveolar Proteinosis* ; Pulmonary Artery ; Reperfusion